USPSTF issues preeclampsia guidance

Low-dose aspirin recommended after 12 weeks gestation for women at high-risk of preeclampsia.

USPSTF issues preeclampsia guidance
USPSTF issues preeclampsia guidance

HealthDay News -- The United States Preventive Services Task Force (USPSTF) is recommending pregnant women at high-risk of preeclampsia be treated with low-dose aspirin after 12 weeks' gestation in a new draft recommendation statement.

In a review of 23 studies, 21 of which were randomized controlled trials, low-dose aspirin therapy resulted in a 24% reduced risk for preeclampsia, a 20% reduced risk for intrauterine growth restriction (IUGR) and a 14% reduced risk for preterm birth, Jillian T. Henderson, PhD, MPH, from Kaiser Permanente Northwest in Portland, Ore., an author on the evidence review, and colleagues determined.

"No harms were identified, but long-term evidence was limited," they wrote in the Annals of Internal Medicine.

Results of the systematic review examining the benefits and harms of low-dose aspirin for preventing preeclampsia-related morbidity and mortality, the researchers found the following across studies:

  • An absolute risk reduction of 2% to 5% for preeclampsia (relative risk 0.76, 95% CI: 0.62-0.95)
  • An aRR of 1% to 5% for intrauterine growth restriction (RR 0.80; 95% CI: 0.65-0.99)
  • An aRR of 2% to 4% for preterm birth (RR 0.86; 95% CI: 0.76-0.98)

Data were included from two large multisite and 13 smaller randomized clinical trials involving high-risk women (eight good quality), as well as six randomized clinical trials and two observational studies of average-risk women (seven good quality).

There was no evidence of significant perinatal mortality (RR 0.92; 95% CI: 0.76-1.11, P=0.65) or maternal harms, although rare harms could not be ruled out.

The timing and dosage of aspirin therapy did not appear to effect outcomes, but preterm birth benefits were greater in studies where patients were assigned to at least 75 mg of aspirin, the task force noted.

"The good news is that pregnant women who are at high risk for developing preeclampsia can take a low dosage of aspirin daily to help to prevent the condition," task force member Jessica Herzstein, MD, MPH, said in a press release.

The draft recommendation statement is available for public comment until May 5, 2014.

References

  1. Henderson JT et al.  Ann Intern Med. 2014; doi:10.7326/M13-2844.
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